Objective: We explored whether passively-collected activity tracker data from consumer wearables could serve as a potential digital biomarker for QoL status based on the PROMIS-10 Global Health Score, a validated mental and physical health QoL metric.
Methods: Study Population: Members of the Achievement health app (a product of Evidation Health) were invited to participate in a 1-year observational study on mental health. Participants were 18 years or older, lived in the U.S., and had a self-reported diagnosis of anxiety or depression. Behavioral and health outcomes data: Participants tracked their daily activity and sleep using consumer wearable activity trackers, and completed quarterly questionnaires assessing their health status, quality of life (PROMIS-10), depression and anxiety symptom severity, and healthcare utilization. Activity tracker data from 3 months pre-enrollment were used to calculate baseline per-participant statistics for over 500 behavioral data features (i.e., activity, step, and sleep metrics). Baseline PROMIS-10 Global Health scores were used to characterize individuals into two cohorts: High QoL and low QoL. Statistical Analysis: A logistic regression model was utilized to identify associations between cohort assignment and univariate behavioral data features, controlling for PHQ-9 and GAD-7 scores, age, sex, race, and socioeconomic status. P-values were adjusted for multiple testing using a false discovery rate (FDR) correction with a significance level of 0.05 for reporting.
Results: Passive monitoring of daily behaviors via consumer wearable activity trackers indicate that higher daily activity levels and greater engagement with sleep tracking is associated with better quality of life (based on PROMIS-10 global mental and physical health scores) in individuals with depression and/or anxiety. Longitudinal analyses assessing how behavioral patterns and PROMIS-10 scores change over time will be conducted in the 1-year analysis to further understand how digital biomarkers can characterize HRQOL. As activity tracker use continues to grow, so do the opportunities to use behavioral data and digital biomarkers to assess changes in health status and health-related quality of life.